<?php 
/**
 * @version			$Id$
 * @author			Richard Asp
 * @package			Joomla
 * @subpackage		gnudoor
 * @copyright		(C) 2010 gnudoor LLC
 * @license      GNU/GPL, see LICENSE.php
 * Joomla! is free software. This version may have been modified pursuant
 * to the GNU General Public License, and as distributed it includes or
 * is derivative of works licensed under the GNU General Public License or
 * other free or open source software licenses.
 * See COPYRIGHT.php for copyright notices and details.
 */

defined( '_JEXEC' ) or die( 'Restriced access' ); ?>



 

<div id="pbbooking" class="request">

<h1>Request an Appointment</h1>


	
<table>
<form action="index.php" method="POST">


<?php

	foreach ($this->customfields as $field) {
		echo '<tr>';
		echo '<td>'.$field['fieldname'].':</td><td><input type="'.$field['fieldtype'].'" name="'.$field['varname'].'" size="'.$field['size'].'"/></td>';
		echo '</tr>';
	}

?>

<tr>
<td>Massage Type:</td><td><select name="massage">
<?php
for ($i=0;$i<count($this->treatments);$i++) {
	echo '<option value='.$i.'>'.$this->treatments[$i]['name'].'</option>';
}
?>
</select></td>
</tr>
<tr>
<td colspan=2 align="center">
<input type="hidden" name="option" value="com_gnudoor">
<input type="hidden" name="controller" value="appointments">
<input type="hidden" name="task" value="save">
<input type="hidden" name="date" value="<?php echo $this->reqdate; ?>">
<input type="hidden" name="timeslot" value="<?php echo $this->reqslot; ?>">
<input type="submit" value="Submit" /></td>
</tr>


</form>
</table>
</div>

<?php
if (isset($this->create_message)) {
	echo $this->create_message;
}

?>